Choledochoduodenostomy: a study of 28 consecutive cases

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Hepatobiliary Surgery

Background:

• Choledocholithiasis, or common bile duct stones, is prevalent in South Asia.
• Adequate bile duct drainage is crucial to prevent residual and recurrent stones.
• Surgical management options for choledocholithiasis require careful consideration.

Purpose of the Study:

• To evaluate the efficacy and safety of side-to-side choledochoduodenostomy for treating choledocholithiasis.
• To highlight surgical management strategies and analyze post-operative complications.

Main Methods:

• A retrospective study of 28 patients with choledocholithiasis treated between 1995 and 2003.
• Diagnosis confirmed pre-operatively and intra-operatively.
• Side-to-side choledochoduodenostomy performed using a single-layer interrupted suture technique.

Main Results:

• The majority of patients (79%) were female, with 43% aged 51-60.
• All patients had a dilated common bile duct (≥1.5 cm diameter), and 71% had multiple stones.
• Post-operative follow-up showed 79% asymptomatic, with low complication rates including wound infection (2 patients) and alkaline reflux gastritis (18%). One patient had recurrent cholangitis due to inadequate stoma size. No sump syndrome was observed.

Conclusions:

• Side-to-side choledochoduodenostomy is an effective and definitive surgical procedure for common bile duct stone management.
• The technique provides excellent decompression, especially in cases of multiple stones within a dilated common bile duct.
• This method demonstrates a favorable safety profile with manageable post-operative complications.